Improving accessibility for people with dementia: web content and research

The Internet can provide a means of communication, searching for information, support groups and entertainment, amongst other services, and as a technology, can help to promote independence for people with dementia. However, the effectiveness of this technology relies on the users’ ability to use it. Web content, websites and online services need to be designed to meet the abilities and needs of people with dementia, and thus the difficulties that these users encounter must be explored and understood.The primary aim of this thesis is to investigate web content accessibility for People with Dementia and develop recommendations for improving current guidelines based on accessibility needs. The secondary aim is to support people with dementia having a voice within research through development of accessible ethical processes.Qualitative data were collected with a scoping study using questionnaires about everyday technology use (people with dementia and older adults without dementia); and in-depth interviews to explore difficulties and web accessibility issues. A document analysis was conducted on Web Content Accessibility Guidelines (ISO/IEC40500:2012) for inclusion of the needs of people with dementia followed by review of Web Usability Guidance (ISO9241-151:2008) to consider how gaps relating to the unmet accessibility needs for people with dementia could be met. The scoping study found that both people with dementia and older adults without dementia use everyday ICT to access the Web. Both groups described difficulties with web interface interactions, which refined the research scope to web content accessibility. The interview data with people with dementia (n=16) and older adults without dementia (n=9) were analysed using Grounded Theory techniques. It was found that both user groups experienced the same types of difficulties using the Web, but that dementia symptoms could exacerbate the difficulties from usability issues (older adults without dementia) into accessibility issues for people with dementia. Navigation was a key issue for both groups, with a range of web content design elements contributing to accessibility issues with navigation for people with dementia. The document analysis found that the accessibility guidance did not address all the accessibility issues encountered by people with dementia. However, the usability guidance did address many of the accessibility issues for web content navigation experienced by people with dementia. The research provides recommendations for improvements to web content accessibility guidelines including content from usability guidelines, and amendments to current guidelines and success criteria. A new ethical recruitment/consent process was developed and tested as part of the research process and is recommended for use in future research to support engagement of people with dementia.</div

Developing personas for use in the design of dementia care environments

Context: Dementia has a high global prevalence, and the number of people with dementia (PWDem) worldwide is expected to rise in coming years. The various symptoms associated with dementia can cause difficulties for PWDem when engaging with activities of daily living (ADLs) as the disease progresses. However, designing a care environment which enables PWDem to successfully engage with ADLs is not a simple task, in part because PWDem may find it difficult to communicate their needs to a design team. For this reason, design personas which aimed to represent PWDem at different stages of the disease were created as a means of communicating these needs to designers. This paper describes an evaluation study on these personas. Objectives: To consult design stakeholders and obtain feedback on the use of the personas in the process of designing a dementia care home. Methodology: Interviews and focus groups were used to obtain feedback on the personas. Main results: Participants suggested several improvements for the personas. These included (1) diagrams (images and symbols) rather than text, (2) focusing less on specific design guidance, and (3) including a wider range of symptoms and needs. Conclusion: The wide range of suggested changes from the participants indicated both engagement with, and potential for, the initial personas. The personas have been revised and will be tested in care homes to explore how far they accurately represent the needs of PWDem both with caregivers and PWDem

How do people living with dementia use technology?

Over 46.8 million people live with dementia worldwide, and this number is set to increase to 131.5 million by 2050; the need to support these people is of paramount importance (Alzheimer’s Disease International, 2015). While research continues to work towards effective treatments, there is need for research to improve the lives of people living with the symptoms (Alzheimer’s Society, 2014); ergonomics and design research has a key role in this challenge. As technology-rich environments are becoming increasingly commonplace, and society becomes increasingly automated, people with dementia (PWD) will be exposed to technological interfaces through necessity as technology becomes impossible to avoid (Wallace, Mulvenna, Martin, et al., 2010). Yet as technologies are developed in a ‘hyper-cognitive society’, where assumptions about cognitive ability are implicit (Brittain, Corner, Robinson, et al., 2010), there becomes an increasing risk of PWD being excluded from society as the demands of technologies are beyond their capabilities. It is therefore important to ensure that technologies are usable by PWD, by identifying and addressing the barriers to technology use. This could lead to a range of future accessible and usable technologies (e.g. everyday ICT, assistive technologies, or telemedicine) for PWD, to support increased independence